保留肋间臂神经在乳腺癌改良根治术中的临床价值

Clinical value of reserving intercostobrachial nerve in the treatment of breast cancer patients by modified radical operation

目的探讨保留肋间臂神经在乳腺癌改良根治术中的临床价值及其预后效果。方法选择2012年1月至2013年6月间收治的行乳腺癌改良根治术的136例乳腺癌患者,采用数字表法随机分为两组,每组各68例。观察组患者在实施乳腺癌改良根治术时注意保护肋间臂神经,对照组则一并清理肋间臂神经,两组患者给予相同的手术治疗和护理,比较两组患者术后上臂和腋部的皮肤感觉情况。结果观察组患者术后1、3和6个月上肢感觉客观异常的分别有1、5和2例,对照组患者术后1、3、和6个月上肢感觉客观异常的分别有34、31和27例,同为感觉异常患者,观察组患者的感觉异常面积也显著小于对照组患者,差异有统计学意义(P<0.05)。结论实施乳腺癌改良根治术的过程中保留肋间臂神经有助于提高患者的生活质量,防止上肢感觉障碍发生。

Objective To investigate the clinical value of reserving intercostobrachial nerve in the treatment of breast cancer patients by modified radical operation. Methods A total of 124 patients with breast cancer were included in this study. Based on the sequence of enrollment, they were randomly divided into two groups, and each group has 62 cases. Patients in observation group were reserved intercostobrachial nerve, while patients in control group were not reserving intercostobrachial nerve, and the same basic opera- tive treatment were used in the two groups. Skin feeling of upper arm and axilla of patients in the two groups were compared. Results At 1, 3 and 6 mo after surgery, the incident of sensory abnormality of intercosto- brachial nerve dominated region of patients in observation group was significantly lower than that of patients in control group, with significant difference （P 〈 0.05）. The feel abnormal area of patients in observation group also significantly less than that in control group, and the difference was statistically significant （ P 〈 0.05）. Conclusion Reserving intercostobrachial nerve in the treatment of breast cancer by modified radi- cal operation can improve patients＇ quality of life and prevent the occurrence of upper limb feel barriers, which is worthy of promotion.